What are growth charts?

At each checkup, the doctor or nurse measures your child's length (or height), weight, and head circumference. Then your practitioner marks those numbers on a chart of averages for children of the same age and sex. In the end, you'll find out what percentile your child is in. (The most up-to-date charts take into account both breastfed and formula-fed babies.)

For example, if the doctor tells you that your 12-month-old daughter is in the 75th percentile for weight, it means that 75 percent of 12-month-old girls weigh the same or less than she does, and 25 percent weigh more. The higher the percentile number, the bigger your child is compared to other children of the same age.

Growth charts show the full range of a child's growth at a specific age. For instance, a height chart for a 2-year-old girl shows the range from shortest to tallest. If your 2-year-old daughter is in the 50th percentile, that means she falls right in the middle and is average height for her age.

Parents sometimes worry needlessly about these percentages. Percentile ratings on a growth chart aren't like grades in school. A lower percentile rating doesn't mean there is anything wrong with your child.

Let's say both parents are shorter than average and their child grows up to have the same stature. It would be perfectly normal for that child to consistently rank in the 10th percentile for height and weight.

Percentile measurements are a general guide to help you and your doctor assess your toddler's growth. What's important is that your child's growth is progressing. Your child's doctor checks to see that your child is growing at an appropriate rate.

Remember that your child is an individual and will develop at her own pace. There's a wide range of healthy shapes and sizes among children. Genetics, activity level, health problems, and nutrition are just some of the factors that can influence growth.

What are doctors looking for?

Your child follows a particular growth curve and your doctor checks to make sure he stays on that curve. Your practitioner makes sure your toddler is gaining weight appropriately each time (no big dips, for example), and keeps an eye on his weight to make sure it isn't excessive for his height. (That might indicate potential weight problems down the road.)

Instead of singling out one percentile number, your child's doctor looks at these measurements together to see an overall growth pattern. Sometimes natural growth spurts or slow-downs can make the numbers vary a bit, but usually your child should stay in roughly the same percentile for height and weight as he grows.

A few different growth patterns can signal a problem. For instance, if your child is in the 40th percentile for height and the 85th percentile for weight, his weight could be an issue. It means that he's taller than 40 percent of the kids his age, but he weighs more than 85 percent of them. He may go through a growth spurt that puts him back at an appropriate height-to-weight ratio, or his doctor may want to look into why his weight is a little high.

Likewise, if your child has consistently registered around the 60th percentile for height at all of his checkups, and then his next checkup finds him in the 30th percentile for height, your doctor will probably want to see if there's a reason he's not growing at the same pace he was before.

Doctors typically use different growth charts, depending on how old your child is. The Centers for Disease Control and Prevention (CDC) suggests that doctors use the World Health Organization's growth charts for the first two years of your baby's life to get the latest and most accurate information.

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